Abstract P514: Clinically Approximated Hypoperfused Tissue in Large Vessel Occlusion Stroke

• Published in: Stroke (1970) 2021-03, Vol.52 (Suppl_1), p.AP514-AP514
• Main Authors: Desai, Shashvat, Ortega, Santiago, Sheth, Sunil, Farooqui, Mudassir, Lopez Rivera, Victor, Zevallos, Cynthia, Abdelkhaliq, Rania, Jovin, Tudor G, Jadhav, Ashutosh
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.52.suppl_1.P514

IntroductionPatient selection for thrombectomy of acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) in the delayed time window (>6 hours) is dependent on delineation of clinical-core mismatch or radiological target mismatch using perfusion imaging. Selection paradigms not involving advanced imaging and software processing may reduce time to treatment and broaden eligibility. We aim to develop a conversion factor to approximately determine the volume of hypoperfused tissue using the NIHSS score [CAT volume (clinically approximated tissue)] and explore its ability to identify patients eligible for thrombectomy in the late time window. MethodsWe performed a retrospective analysis of anterior circulation LVO strokes at three comprehensive stroke centers. Demographic, clinical (NIHSS score, TLKW-time last known well) and imaging [computed tomography with perfusion (CTP) processed using RAPID, IschemaView] information was analyzed. A conversion factor, which is a multiple of the NIHSS score (one multiple for NIHSS score 6 seconds volume) was tested using DEFUSE-3 criteria eligibility as a gold standard. ResultOf the 309 LVO strokes [mean age of 70 ±14, 46% male, median NIHSS 16 (12-20)] included in this study, 38% of patients arrived beyond 6 hours of TLKW. Conversion factors derived (derivation cohort-center A:187) based on median (50th percentile) values of Tmax >6s volume for NIHSS